Box 3.

Monitoring and control program for the management of MDR-carriers

At the “Luigi Vanvitelli” teaching Hospital in Naples, a persuasive-educational program on the management of patients MDR-carriers was initiated in 2019. It was based on audit and feedback conducted by a team of consultants in infectious diseases, clinical microbiology, and hygiene. The departments included in this program were those managing high-risk patients, specifically, nephrology, oncology, geriatrics, infectious diseases, general surgery, and 2 ICUs. All the consultants were responsible for writing and sharing protocols for the screening and the management of the MDR-carriers: all patients in the wards participating in the program were screened for the rectal presence of CRE and nasal presence of MRSA on admission and every 7 days during the hospitalization. The microbiology unit informed infectious disease and hygiene specialists of a positivity to allow for better management of the patient; these specialists performed audits within 48 h to evaluate the management of isolation according to approved protocols, and adherence to these indications was assessed. This program, through collaborative work among consultants in infectious diseases, clinical microbiology, and hygiene, has improved the awareness of staff in the departments included in the program about the management of MDR carriers.